Trouble Seeing at Night? It Might Be Peripheral Vision Loss: Here’s How To Tell
An eye doctor explains why loss of peripheral vision may be one of the first signs of glaucoma
When you think of vision trouble, you might look at the issue head-on—literally. Determining how well you can see right in front of you is often the gauge for whether or not it’s time for a comprehensive eye exam. But even if your central vision is intact, you may find it hard to see out of the corners of your eyes. When this happens, it’s known as peripheral vision loss (PVL), or tunnel vision. Here’s what you need to know about this eye condition, including what can cause it and how it can even affect your night vision.
What peripheral vision loss looks like
“Peripheral vision refers to the field of vision outside of the center,” says Shivani Kamat, MD, clinical spokesperson for the American Academy of Ophthalmology (AAO). “This is used for being aware of your surroundings and is less detailed than central vision.”
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It can be difficult to notice peripheral vision loss, but Dr. Kamat says some common signs include:
- Difficulty seeing at night, especially when driving
- Being less aware of your surroundings (i.e., having a blind spot). This can make it difficult to navigate crowded spaces
- Having to turn your head to see something off to the side
What causes peripheral vision loss?
“Gradual peripheral vision loss is often caused by glaucoma, an ocular disease that leads to progressive loss of function of the optic nerve,” says Dr. Kamat. This happens when fluid build-up in the eye increases pressure. “In most forms of glaucoma, loss of peripheral vision happens first due to the way the disease impacts the optic nerve and the sensory fibers it contains.”
Other conditions that can lead to PVL include:
- Retinal detachment
- Retinitis pigmentosa, a genetic disorder that affects the retina
- Diabetic retinopathy, a complication from diabetes that affects vision
- Optic neuritis, inflammation of the optic nerve
Family history can contribute to loss of side vision
“People with a known family history of glaucoma are more likely to develop the disease themselves,” says Dr. Kamat. If left untreated, this can lead to complications like peripheral vision loss.
“To screen for this, a dilated exam can be performed with an ophthalmologist and tests performed to assess the integrity of the peripheral visual field,” says Dr. Kamat. “If you have ever been told that your eye pressure is higher than normal, this can also be a potential risk factor and warrants additional screening.”
Even without a family history, the risk of glaucoma increases with age. That’s why Dr. Kamat says it’s important to get a regular dilated exam with an ophthalmologist every one to two years. For those who don’t have insurance that covers this, the AAO offers no-cost eye exams with an ophthalmologist for patients with increased risk factors, like age. See if you qualify here.
Routine eye exams are vital for catching peripheral vision loss
“There are no definite preventive treatments for PVL, so routine eye exams are a good idea as a screening tool to assess one’s individual risk to develop the disease,” Dr. Kamat says. “Patients with progressive disease are often referred to glaucoma specialists who have further training beyond a comprehensive ophthalmologist.”
Another smart move: Keeping up regular physical activity. Research shows that exercise reduces eye pressure, which may lower the risk of cataracts that contribute to peripheral vision loss. When peripheral vision loss is caused by a progressive eye disease like cataracts, it can be permanent. Fortunately, an ophthalmologist can treat it to prevent the vision loss from getting worse.
If the cause of your peripheral vision loss is a retinal detachment, which may cause sudden loss of peripheral vision in one eye, there are several treatment options. They may include laser treatment, cryotherapy or surgery based on health history. In this situation, peripheral vision loss may be temporary.
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